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中华诊断学电子杂志 ›› 2016, Vol. 04 ›› Issue (04) : 226 -230. doi: 10.3877/cma.j.issn.2095-655X.2016.04.003

所属专题: 文献

肿瘤诊治研究

磁共振T2加权成像联合弥散加权成像对前列腺癌包膜外扩散的预测价值
张立涛1, 李秀娟1, 韩耀启1, 朱晓琳1, 谢元忠1,()   
  1. 1. 271000 泰山医学院附属泰安市中心医院医学影像部
  • 收稿日期:2016-05-14 出版日期:2016-11-26
  • 通信作者: 谢元忠

Predictive value of T2 weighted imaging combined with diffusion magnetic resonance imaging for extracapsular extension in patients with prostate cancer

Litao Zhang1, Xiujuan Li1, Yaoqi Han1, Xiaolin Zhu1, Yuanzhong Xie1,()   

  1. 1. Department of Medical Imaging, Tai’an Central Hospital, Tai’an 271000, China
  • Received:2016-05-14 Published:2016-11-26
  • Corresponding author: Yuanzhong Xie
  • About author:
    Corresponding author: Xie Yuanzhong, Email:
引用本文:

张立涛, 李秀娟, 韩耀启, 朱晓琳, 谢元忠. 磁共振T2加权成像联合弥散加权成像对前列腺癌包膜外扩散的预测价值[J]. 中华诊断学电子杂志, 2016, 04(04): 226-230.

Litao Zhang, Xiujuan Li, Yaoqi Han, Xiaolin Zhu, Yuanzhong Xie. Predictive value of T2 weighted imaging combined with diffusion magnetic resonance imaging for extracapsular extension in patients with prostate cancer[J]. Chinese Journal of Diagnostics(Electronic Edition), 2016, 04(04): 226-230.

目的

回顾性评估磁共振T2加权成像(T2WI)联合弥散加权成像(DWI)对前列腺癌(PCa)包膜外扩散(ECE)的预测价值。

方法

60例术前行3.0T磁共振检查的PCa患者,依据影像资料和病理组织学检查结果,将患者分为ECE组和无ECE组。由2名影像学诊断医师对磁共振T2WI和T2WI联合DWI图像进行分析,评估PCa的ECE情况,并测量ECE组和无ECE组表观弥散系数(ADC)值,比较PCa ECE组和无ECE组的ADC值差异性。本研究经泰安市中心医院医学伦理委员会审核通过。

结果

磁共振T2WI和T2WI联合DWI的敏感度与特异度分别为76.1%、84.3%。ROC分析显示,磁共振T2WI联合DWI曲线下面积明显大于磁共振T2WI曲线下面积(Az=0.892,0.803,Z=4.661,P<0.01)。ECE组ADC值[(0.72±0.14)×10-3mm2/s]明显低于无ECE组[(0.94±0.21)×10-3mm2/s](t=3.82,P<0.01)。

结论

磁共振T2WI联合DWI图像能够提高预测PCa患者ECE情况,ADC值对评估有无ECE具有重要参考价值。

Objective

To explore the value of T2-weighted imaging (T2WI) combined with diffusion-magnetic resonance imaging (DWI) for the prediction of extracapsular extension (ECE) in patients with prostate cancer (PCa).

Methods

Sixty patients with PCa who underwent 3T MRI were divided into ECE group and no ECE group according to imaging data and pathological histology.Pictures of T2WI alone and T2WI combination with DWI were analyzed by two experienced imaging physicians, and apparent diffusion coefficient (ADC) values of tumor were measured, furthemore compared between two groups.

Results

The sensitivity and specificity of T2WI combined with DWI were 76.1% and 84.3%, respectively, which were superior to those of T2WI alone.The area under the curve (Az) of T2WI combined with DWI on receiver operating characteristic analysis was significantly higher than that of T2WI alone (Az=0.892, 0.803, Z=4.661, P<0.01). The mean ADC value was significantly lower in patients with ECE [(0.72±0.14)×10-3mm2/s] than that in patients without ECE [(0.94±0.21)×10-3mm2/s] (t=3.82, P<0.01).

Conclusions

T2WI combined with DWI enhances the potential for predicting ECE status in patients with PCa.In addition, ADC value has important value to assess patients with or without ECE.

表1 前列腺癌患者一般临床特征比较( ±s)
图1 前列腺癌患者前列腺磁共振T2WI、DWI、ADC影像图。a~c 图,T2WI显示外周带软组织结节影,轮廓不规则,DWI显示弥散受限,ADC图呈低信号,病灶向包膜外扩散,Gleason评分4+3;d~f图,T2WI 显示中央带内异常信号病灶,Gleason评分3+3,无包膜外扩散(箭头所示)
图2 前列腺癌患者磁共振T2WI与T2WI+DWI ROC分析图。磁共振T2WI的Az=0.803(┅),T2WI与DWI的Az=0.892(━)
表2 前列腺癌患者磁共振T2WI和T2WI联合DWI对包膜外扩散预测水平(%)
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